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 Medical bills leading cause of bankruptcy  Premium costs rising faster than wages  No protections for people with pre-existing conditions  Insurance companies can deny coverage to sick people, even children

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 Can’t be denied coverage because of a pre- existing condition  No lifetime limits or annual caps on coverage  Limits on out-of-pocket costs for consumers  Companies can’t charge women more money for same coverage  Companies can’t cancel your policy because of an illness

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 Job-based coverage ◦ >50% of non-elderly North Carolinians ◦ Most will continue on this coverage in 2014  Don’t have to apply, but can shop around to see if better coverage or better costs  Benefit from consumer protections, such as caps on lifetime limits, protections for pre- existing conditions, etc.

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 How do premium tax credits work? ◦ Used to purchase qualified health plan on Marketplace ◦ Eligibility determined by household size and income ◦ Can be claimed fully in advance, in part in advance, or at end of year ◦ Paid directly by the Marketplace to the insurer ◦ Consumer is responsible for the difference each month 12

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 CHIP ◦ Public program that covers children in families up to 200% FPL (~$47k for family of four)  Medicaid ◦ Public program that covers some individuals & families ◦ Provides funding to states to expand eligibility for all individuals up to 138% FPL  Supreme Court rendered expansion voluntary for states  12 month eligibility period — can enroll anytime in the year

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 ACA provides full federal funding for expansion for first three years  Tapers down to 90% in 2020 and years beyond

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 The North Carolina Department of Insurance (NCDOI) consumer information office can help you with questions about your insurance coverage ◦ Health Insurance Smart NC ◦ 1-877-885-0231 ◦ www.ncdoi.com/Smart/ www.ncdoi.com/Smart/  NCDOI can also help you file complaints or appeals with your insurance company 19